Acta Neurologica Taiwanica · Oct 29, 2026

Triglyceride-Glucose Index and Incident Stroke in Elderly Patients with Type 2 Diabetes: A Retrospective Cohort Study

By Prakongyot C, Thohnabutr K, Sopa N et al.

BACKGROUND: The triglyceride-glucose (TyG) index is a surrogate marker of insulin resistance and has been associated with stroke in general populations. However, evidence regarding its prognostic value for incident stroke in elderly patients with type 2 diabetes mellitus (T2DM) remains limited. OBJECTIVES: To evaluate the association between the TyG index and incident stroke in elderly patients with T2DM. A retrospective cohort study conducted at a provincial tertiary care center in Northern Thailand. MATERIALS AND METHODS: This study included 1024 patients aged ≥60 years with T2DM. The TyG index was calculated from fasting triglyceride and fasting plasma glucose levels at baseline and categorized into quartiles. The primary outcome was computed tomography-confirmed incident stroke during a 5-year follow-up. Cox proportional hazards regression models were used to estimate hazard ratios and 95% confidence intervals, adjusting for age, sex, hypertension, and smoking status. Kaplan-Meier survival analysis and Cox proportional hazards regression. RESULTS: Over a mean follow-up of 4.7 years, 51 patients (5.0%) developed incident stroke. Although higher TyG index quartiles were associated with less favorable metabolic profiles, no significant differences in stroke-free survival were observed across TyG quartiles. In multivariable analyses, the TyG index was not independently associated with incident stroke, whether analyzed as quartiles or as a continuous variable. CONCLUSIONS: The TyG index was not associated with incident stroke in elderly patients with T2DM, suggesting limited prognostic utility of the TyG index for stroke risk prediction in this population.

doi.org/10.4103/ant.ant-d-26-00010Open accessPubMed 42954440Biomarkers